What is the indication for bivalirudin?

Bivalirudin is indicated for use in patients undergoing percutaneous coronary intervention (PCI), in patients at moderate to high risk acute coronary syndromes due to unstable angina or non-ST segment elevation in whom a PCI is planned.

What drug class is bivalirudin?

Bivalirudin is a medication used to manage and treat patients undergoing percutaneous coronary intervention for acute myocardial infarction. It is in the direct thrombin inhibitor class of drugs.

How do you administer bivalirudin?

The recommended dose of bivalirudin for patients undergoing PCI is an intravenous bolus of 0.75 mg/kg body weight followed immediately by an intravenous infusion at a rate of 1.75 mg/kg body weight/hour for at least the duration of the procedure.

How do you monitor bivalirudin?

At UWMC, bivalirudin is monitored using the Direct Thrombin Inhibitor (DTI) assay (Plasma-Diluted Thrombin Time). Used instead of aPTT to monitor injectable DTI therapy. Preferred over aPTT due to better sensitivity, and is not affected by antiphospholipid antibodies.

When do you use argatroban vs bivalirudin?

Average time to initial therapeutic anticoagulation was 4.71 hours and 9.8 hours for the argatroban and bivalirudin groups, respectively (P < . 01). Conclusions: Argatroban may be advantageous compared to bivalirudin in achieving initial therapeutic anticoagulation goals among patients with suspected or confirmed HIT.

Is bivalirudin approved for HIT?

Bivalirudin is the most recent direct thrombin inhibitor to be introduced to the market, but it is not currently FDA approved for HIT.

What is the aPTT goal for bivalirudin?

Bivalirudin infusions were initiated at 0.05 to 0.3 mg/kg/hr. The aPTT goals were determined for each patient individually based on underlying disease and risk factors. The median time to achieve an aPTT level within the goal range was 4 hours, with a range of 1 to 25 hours.

How fast does bivalirudin work?

Bivalirudin monotherapy provided superior net clinical outcomes compared to any heparin regimen with GP IIb/IIIa inhibitor (10.1% vs 11.7%) at 30 days.

What is the half life of bivalirudin?

Bivalirudin is cleared from plasma by a combination of renal mechanisms and proteolytic cleavage, with a half-life of approximately 25 min in patients with normal renal function.